Due to the high morbidity, mortality and late detection of hepatocellular carcinoma (HCC), it becomes a major public health challenge. MicroRNAs (miRNAs) have been reported to be aberrantly expressed in patients with HCC and thus may serve as potential diagnostic biomarkers. The aim of this study was to systematically assess the diagnostic accuracy of miRNAs as biomarkers for diagnosing HCC through a meta-analysis. Our results indicated that serum miRNAs had a relatively high diagnostic value for HCC diagnosis; the combination of serum α-fetoprotein (AFP) and miRNAs displayed a better diagnostic accuracy than using AFP or miRNAs alone; the combination of multiple miRNAs assay in serum had the highest diagnostic accuracy in HCC diagnosis based on the published data. In conclusion, our meta-analysis suggests that miRNAs, especially serum miRNAs, had a relatively high diagnostic value for HCC diagnosis, which can discriminate HCC from healthy subjects and those with chronic hepatitis and cirrhosis easily, and may serve as a novel, less-invasive screening tool.